广东省东莞地区结核病控制措施与起始耐药状况分析

Analysis on current situation of tuberculosis control project and initial drug resistance rate of pulmonary tuberculosis in Dongguan city

目的掌握东莞地区肺结核病人起始耐药特征,评价本地区结核病控制实施效果。方法采用WHO制定的全球结核病耐药监测方案,使用比例法对东莞地区初治涂阳肺结核病人进行耐药性测定。结果558例肺结核病人的初始耐药率为18.1%,以耐链霉素(9.9%)及异烟肼(11.6%)为主,50.5%的耐药病人耐1药,耐利福平和异烟肼2药及以上病人的耐药率为5.7%。但初始耐药病人的化疗效果较好。结论东莞地区肺结核初始耐药水平较高,应进一步加强结核病控制工作。

Objective To evaluate the effect of tuberculosis control program carried out in Dongguan city and to determine the initial drug resistance level.Method Drug resistance surveillance （DRS） was implemented in Dongguan according to WHO/IUATLD Guidelines for Surveillance of Drug Resistance in Tuberculosis （ 1994）. The proportional method was used for new smear-positive pulmonary tuberculosis without history of anti - tuberculosis drug use. Results Among 558 cases, the rate of initial resistance was 18.1%. The resistant rate to isoniazid was 9.9 % and streptomycin was 11.6 %. Those two drugs were the major resistance drugs. The resistant rate to one drug was 50.5 % among the patients with resistance results. The treatment outcomes were good not only in new susceptibility cases but also in initial drug resistant cases. Conclusion The result revealed that the drug resistance level in Dongguan was high. Therefore, TB control program should be further strengthened.